Tuesday, August 24, 2010

Consulting grief

Do you remember that postnatal check-up with your obstetrician; the final appointment eight weeks after giving birth to your baby?

I do. And to be honest, I felt a little sad ending a relationship with the doctor who delivered my baby. The finality of it, made it feel like a 'goodbye' I'd say to an old mate heading overseas to live.

It wasn't until a friend of mine popped over with her baby, just shy of four months, that I realised this could be a common feeling. We had shared obstetricians (two of them, since our first had retired) and were reminiscing about check-ups when she said, "You know I feel kind of sad that I don't see him any more." And I knew exactly what she meant.

Each pregnancy I had to help a little baby thrive in utero. A job I did with some expert guidance regularly overseeing the project. That doctor had to listen to all my anxieties about the health of the baby, the impending birth and any other concern I could think of (hormone-fuelled nuerosis). All of the sudden, once my baby came out, that guidance was gone. My fortnightly appointments were swapped with child health nurse visits and it was time to get on with the job of parenting this child.

Don't get me wrong, this wasn't a school-girl crush (my first OB was at retiring age, remember?)! It was more like a little hero-worshipping. I idolised these doctors that knew so much. I was so appreciative of the eight-minute visits I had with them that I'd write my questions up in advance, just to soak up all that time in their surgery rooms.

Not only did I adore these doctors, I was consumed with trying to get to know everything about them. Who were these men checking the beats of my baby's heart and what were their wives like? Were those women also grateful for their partner's on-tap advice? How many children did they have; natural or Ceasar; breast or bottle; and, what age gap between said kids? Every trivial question that I'd discussed with my mums group, I was wondering about these doctors. And I know some of the other mums were thinking them too. While the kids were making sand castles at playgroup we were discussing the amount of children our obstetrician had and whether the rumour of his wife expecting twins was true (it was).

What is it with antenatal care that brings out the craziness in women? I've been visiting the same dentist twice a year for the past 20 years and I know he has kids the same age as mine, but I don't care. I have no desire to know about his out-of-hours life, so why the intense interest in the obstetrician?

Williamstown Psychology's Camille Folley, a psychologist specialising in postnatal parents, said the bond between a woman and her obstetrician may be formed (particularly during the pregnancy of a first child) "because of the continuity of care provided by this person and the support [a mother] gets from that relationship. Women who had a positive experience will report positively and often speak of their obstetrician fondly."

I considered women who chose to have their babies in the public system, where continuity of care is harder to come by, did they experience this attachment with their on-duty midwife? I can imagine that women who hire private midwives for home births might experience a more intense relationship with their care providers, as they meet with them in their ownhome regularly over the nine months.

Ms Folley said the relationship ends at a busy time that can be somewhat challenging and confusing as women transition into their role as mothers. And there's nothing quite like the conversation at a postnatal check-up to finalise the chapter of pregnancy with your doctor. Suddenly the euphoria of birth fizzles out when it's time to talk about pelvic floor maintenance and effective contraception.

You might have left your doctor's rooms, hoping to be back in two years with another bundle of joy. After having three children, I said goodbye and walked out knowing this would definitely be the end of our relationship. And I was looking towards the next phase: walking around without a nappy bag!